Fri Nov 24 2023

147 articles - From Friday Nov 17 2023 to Friday Nov 24 2023

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Am J Gastroenterol

Diagnosis and Management of Biliary Strictures: A Clinical Practice Guideline Dissemination Tool.

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Gastroenterology

AGA Clinical Practice Guideline on the Role of Biomarkers for the Management of Crohn's Disease.

In patients with CD, fecal calprotectin and serum CRP can inform disease management in both asymptomatic and symptomatic disease. Discordance between symptom assessment and biomarker value may merit endoscopic evaluation for confirmation of status of disease activity.

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AGA Clinical Practice Update on the Use of Vasoactive Drugs and Intravenous Albumin in Cirrhosis: Expert Review.

BEST PRACTICE ADVICE 12: Terlipressin use is contraindicated in patients with hypoxemia and in patients with ongoing coronary, peripheral, or mesenteric ischemia, and should be used with caution in patients with acute-on-chronic liver failure grade 3. The benefits may not outweigh the risks in patients with serum creatinine >5 mg/dL and in patients listed for transplantation with a Model for End-stage Liver Disease =35.

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Gastrointest Endosc

Meeting the environmental challenges of endoscopy: a pathway from strategy to implementation.

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Hepatology

Letter To The Editor: A multi-society delphi consensus statement on new fatty liver disease nomenclature.

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Reply: A multi-society delphi consensus statement on new fatty liver disease nomenclature.

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Meta-analysis

meta-analyses and systematic reviews

Aliment Pharmacol Ther

Meta-analysis: Impact of intragastric balloon therapy on NAFLD-related parameters in patients with obesity.

Intragastric balloons may play an important role in addressing the treatment gap in NAFLD management.

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Hepatology

Diagnostic accuracy of AGILE3+ score for advanced fibrosis in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis.

Our systematic review and meta-analysis suggest that Agile3+ accurately diagnoses NAFLD with advanced fibrosis and can identify patients eligible for biopsy and emerging pharmacotherapies.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

The polymorphic variant of SerpinB3 (SerpinB3-PD) is associated with faster cirrhosis decompensation.

The polymorphic variant SB3-PD is highly effective in determining activation of TGF-ß1 and inflammation in vitro. Patients with cirrhosis who carry SB3-PD polymorphism may be more prone to develop severe liver disease progression. However, further validation studies are warranted to support the in vivo relevance of this polymorphism.

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Am J Gastroenterol

Changes in Therapy Are Not Associated with Increased Remission in Patients with Crohn's Disease of the Pouch.

Approximately 50% with symptoms at enrollment achieved clinical remission at 12 months, the majority of whom did so without a change in therapy.

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Characterizing the Impact of Disorders of the Gut-Brain Interaction (DGBI) on Mental and Physical Health Functioning among Spanish-Speaking Latino Adults Living in the U.S.

Better understanding mental health and treatment seeking behaviors among Latino individuals may help clinical gastroenterologists engage their Latino patients to a greater extent and thus provide higher quality of care.

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Comprehensive Assessment of Nutrition and Dietary Influences in Hypermobile Ehlers Danlos Syndrome (CANDI-hEDS) - a cross sectional study.

Altered diet is very common in the hEDS/HSD patients we studied and influenced by functional dyspepsia, reflux symptoms and ARFID. Those with ARFID have a four-fold increased risk of requiring nutrition support and therefore, it is paramount that psychological support is offered in parallel with dietary support in the management of DGBI in hEDS/HSD.

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Effectiveness of Helicobacter pylori treatments according to antibiotic resistance.

In regions where the antibiotic resistance rate of H. pylori is high, eradication treatment with the three-in-one single-capsule, the quadruple with bismuth and concomitant with tinidazole are the best options in naïve patients. In non-naïve patients, the three-in-one single-capsule and the triple therapy with levofloxacin provided encouraging results.

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Increased Grades of Rectal Intussusception: Role of Decline in Pelvic Floor Integrity and Association with Dyssynergic Defecation.

Our data suggests that decline in pelvic floor integrity with abnormal levator ani laxity is associated with increased RI grades; a process that is independent of age, history of vaginal deliveries and/or pelvic surgeries, and perhaps related to dyssynergic defecation.

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Patients with Esophageal Adenocarcinoma with prior GERD symptoms are similar to those without GERD: A Cross-sectional Study.

Esophageal adenocarcinoma patients with and without prior GERD symptoms are phenotypically similar, suggesting that BE screening efforts to prevent or detect early EAC should not be restricted to just those with GERD.

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Proportion Time Covered by Hepatocellular Carcinoma Surveillance in Patients with Cirrhosis.

The proportion time covered by HCC surveillance in patients with cirrhosis remains low, highlighting a need for multi-level interventions.

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RACIAL DISPARITY IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA TREATMENT AND SURVIVAL IN THE UNITED STATES.

Black individuals with ESCC have a lower survival than White individuals. This could be related to presenting at a later stage, but also disparities in which treatments they receive even among individuals with the same stage of disease. To what extent these disparities in receipt of treatment is due to structural racism, social determinants of health, implicit bias, or patient preferences deserves further study.

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Risk of Esophageal Cancer in Achalasia: A Matched Cohort Study Utilizing the Nationwide Veterans Affairs Achalasia Cohort (VA-AC).

Based on substantial EC risk, individuals with achalasia may benefit from a high index of suspicion and endoscopic surveillance for EC.

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Ten-day vonoprazan-amoxicillin dual therapy versus standard fourteen-day Bismuth-based quadruple therapy for first-line Helicobacter pylori eradication: a multicenter randomized clinical trial.

The 10-day VA-dual therapy provided satisfactory eradication rates of >90% (PP analysis), lower rates of adverse events compared with standard 14-day B-quadruple therapy as first-line H. pylori therapy. Trail registration number ChiCTR2300070100.

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Clin Gastroenterol Hepatol

A liver stiffness-based etiology-independent machine learning algorithm to predict hepatocellular carcinoma.

The SMART-HCC score is a useful machine learning-based tool for clinicians to stratify HCC risk in patients with CLDs.

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Effects of Mirikizumab on Histologic Resolution of Crohn's Disease in a Randomized Controlled Phase 2 Trial.

In a post-hoc analysis of phase 2 data, mirikizumab induced and sustained histologic response and remission in CD over 52 weeks. Early combined histologic-endoscopic response was associated with endoscopic remission after 1 year of treatment with mirikizumab (ClinicalTrials.gov NCT02891226.

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Prolonged gastrointestinal manifestations after recovery from COVID-19.

In this follow-up survey of patients 12-18 months after hospitalization with COVID-19, there was a high prevalence of DGBIs and persistent GI symptoms. Prolonged gastrointestinal manifestations were associated with the severity of GI symptoms during hospitalization and with the degree of psychological trauma related to the illness experience.

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Endoscopy

Initiatives to increase colonoscopy capacity - is there an impact on polyp detection? A UK National Endoscopy Database analysis.

Strategies to increase colonoscopy capacity may have adverse effects on polyp detection. Routine quality monitoring should be undertaken following such initiatives. Meantime, reasons for this unwarranted variation require investigation.

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Gastroenterology

Cholangiocytes modulate CD100 expression in the liver and facilitate pathogenic Th17 differentiation.

CD100 exerts its functional impact through cholangiocyte-immune cell crosstalk and underscores an active, proinflammatory role of cholangiocytes that can be relevant to novel treatment approaches.

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Proteomic characterization identifies clinically relevant subgroups of gastrointestinal stromal tumors.

Our study provides a valuable data resource and highlights potential therapeutic approaches for GIST.

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RET Signaling Persists in the Adult Intestine and Stimulates Motility by Limiting PYY Release from Enteroendocrine Cells.

RET signaling normally limits nutrient-dependent peptide release from L-cells and this activity is necessary for normal intestinal motility in male mice. These effects could contribute to dysmotility in HSCR, which predominantly affects males, and uncovers a mechanism that could be targeted to treat post-prandial GI dysfunction.

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Gastrointest Endosc

A strategy combining endoscopic hand-suturing with clips for closure of rectal defects after endoscopic submucosal dissection with or without myectomy (with video).

EHS-Clips can be used to effectively close the rectal defects after ESD or ESD-ME and prevent DB. Complete suture with a stitch margin of = 5 mm may achieve more reliable sustained closure.

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Comparison of adenoma miss rate and adenoma detection rate between conventional colonoscopy and colonoscopy with second generation distal attachment cuff: a multicenter, randomized, back-to-back trial.

Our trial shows that EVC reduces the risk of missing adenomas but does not lead to a significant improved ADR. Remarkably, 25% of adenomas are still missed during conventional colonoscopies, which is not different from miss rates reported 25 years ago; reassuringly, advanced features were only found in 3.7% of these missed lesions. Trail registration number NCT03418948.

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Endoscopist Adenoma Per Colonoscopy Detection Rates and Risk for Post Colonoscopy Colorectal Cancer: Data From New Hampshire Colonoscopy Registry.

Cox regression was used to model the hazard of PCCRC on APC, controlling for age, sex, year of index exam, index findings, bowel preparation and having more than 1 surveillance exam. Results In 32,535 patients, a lower hazard for PCCRC (n=178) was observed for higher APCs as compared to APCs 25%.

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Long-Term Prognosis and Risk Factors Associated with Post-ERCP Pneumobilia in Patients with Common Bile Duct Stones.

Patients with post-ERCP pneumobilia have increased risk of multiple recurrences of CBDSs and acute cholangitis without stone recurrence. Independent risk factors for pneumobilia include peripapillary diverticulum, a dilated CBD (>1 cm), and EST with moderate and large incisions. A normal-sized CBD appears to serve as a secondary barrier against enterobiliary reflux, necessitating further research for confirmation.

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The 2022 top 10 list of endoscopy topics in medical publishing: an annual review by the American Society for Gastrointestinal Endoscopy Editorial Board.

The 10 identified areas collectively represent advances in the following endoscopic spheres: artificial intelligence, endoscopic submucosal dissection, Barrett's esophagus, interventional EUS, endoscopic resection techniques, pancreaticobiliary endoscopy, management of acute pancreatitis, endoscopic environmental sustainability, the NordICC trial, and spiral enteroscopy. Each board member was assigned a consensus topic area around which to summarize relevant important articles, thereby generating this précis of the "top 10" endoscopic advances of 2022.

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Validation of a new optical diagnosis training module to improve dysplasia characterization in inflammatory bowel disease: a multicenter international study.

The OPTIC-IBD training module demonstrated that an online platform could improve participants' accuracy and confidence in the optical diagnosis of dysplasia in patients with IBD. The training platform can be widely available and improve endoscopic care for people with IBD. NCT04924543.

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Gut

Chimeric antigen receptors of HBV envelope proteins inhibit hepatitis B surface antigen secretion.

CARs possess direct antiviral activity, besides the well-known application in T-cell therapy. Fc attached G12-scFv and G12-CARs could provide a novel approach for reducing circulating HBsAg.

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Understanding the malignant potential of gastric metaplasia of the oesophagus and its relevance to Barrett's oesophagus surveillance: individual-level data analysis.

SS-GM is a distinct entity from SS-IM and the malignant potential of GM is lower than IM. It is questionable whether SS-GM warrants inclusion in BO surveillance.

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Hepatology

A multicellular liver organoid model for investigating hepatitis C virus infection and non-alcoholic fatty liver disease progression.

Taken together, we introduced a multicellular LO model consisting of hepatocytes, Kupffer-like cells, and HSCs, which recapitulated host-virus intercommunication and inter-cellular interactions. With this novel model, we present a physiologically relevant system for the investigation of NAFLD progression in HCV patients.

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Benefit and harm of waiting time in liver transplantation for HCC.

Enhancing our understanding of HCC tumor biology through the analysis of subtypes and molecular genetics holds significant promise in advancing the personalized approach for patients. In this review, the effect of waiting time duration on outcome in patients with HCC enlisted for LT is discussed.

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Evaluation of terlipressin-related patient outcomes in hepatorenal syndrome-acute kidney injury using point-of-care echocardiography.

Cirrhotic cardiomyopathy and reduction in cardiac index, reliably predict terlipressin non-response. CCM is independently associated with poor survival in HRS-AKI.

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Genetic landscape of pediatric acute liver failure of indeterminate origin.

This study elucidates a large contribution of genetic causes in PALF of indeterminate origin with an increasing spectrum of disease entities. The high proportion of diagnosed cases and potential treatment implications argue for exome or in future rapid genome sequencing in PALF diagnostics.

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Immunogenomics of cholangiocarcinoma.

Functionally uncoupling the tumor-promoting or tumor-suppressing roles of immune profiles will be critical for identifying new immunomodulatory treatment strategies and associated biomarkers for patient stratification. This review will discuss the immunogenomics of cholangiocarcinoma, including the impact of genomic alterations on immune functionality, subversion of the cancer-immunity cycle, as well as clinical implications for existing and novel treatment strategies.

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LRH-1 agonist DLPC through STAT6 promotes macrophage polarization and prevents parenteral nutrition associated cholestasis in mice.

These results indicate that activation of LRH-1 by DLPC may protect from PNAC liver injury through STAT6-mediated macrophage polarization.

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Nuclear acly protects liver from ischemia-reperfusion injury.

Our results indicate that Acly regulates histone modification via nuclear AcCoA production in hepatic IR. Disruption of Acly nuclear translocation increases the vulnerability of steatotic liver to IR. Nuclear Acly thus may serve as a potential therapeutic target for future interventions in hepatic IR injury, particularly in the context of steatosis.

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Prevalence and characteristics of Hepatitis delta virus infection in patients with hepatitis b in the united states: An analysis of the All-Payer Claims Database.

In a large database capturing approximately 80% of the US insured population, HBV/HDV infection prevalence was 4.6% among HBV-infected adults. HDV-infected patients had high rates of baseline liver complications and other comorbidities at time of diagnosis, suggesting potentially delayed diagnosis and/or treatment. Earlier identification of HBV/HDV infection among the HBV population may provide opportunities to improve linkage to care and treatment, thereby reducing the risk of liver-related morbidity and mortality.

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Single-cell dissection of the multicellular ecosystem and molecular features underlying microvascular invasion in hepatocellular carcinoma.

This study provides a comprehensive single-cell atlas of MVI in HCC, shedding light on the complex multicellular ecosystem and molecular features associated with MVI. These findings deepen our understanding of the underlying mechanisms driving MVI and provide valuable insights for improving clinical diagnosis and developing more effective treatment strategies.

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J Hepatol

Adipose tissue macrophage dysfunction is associated with a breach of vascular integrity in NASH.

NAFLD-related macrophage dysfunction coincide with a loss of adipose tissue vascular integrity providing a strong plausible mechanism by which tissue inflammation is perpetuated in adipose tissue and downstream in the liver. Impact and implications Our study describe for the first time the myeloid cell landscape in human visceral adipose tissue at single cell level within a cohort of well-characterised NAFLD patients. We report unique NASH-specific transcriptional changes within metabolically active macrophages (MMacs) and resident vasculature-associated macrophages (ResVAM) and we demonstrate their spatial location surrounding the vasculature. These dysfunctional transcriptional macrophage states, coincided with the loss of adipose tissue vascular integrity, providing a strong plausible mechanism by which tissue inflammation is perpetuated in adipose tissue and downstream in the liver. Our study provide a theoretical basis for new therapeutic strategies to be directed towards reinstating ResVAM and MMac endogenous metabolic and homeostatic and cytoprotective mechanisms including their function to protect the vascular integrity and barrier.

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Association between public health policies on alcohol and worldwide cancer, liver disease and cardiovascular disease outcomes.

The API is a valuable instrument to quantify the robustness of alcohol-related PHP establishment. Those countries with a higher API were associated with lower AUD prevalence, ALD mortality, neoplasms, alcohol-attributable HCC, and cardiovascular diseases. Our results encourage the development and strengthening of alcohol-related policies worldwide.

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Characteristics and outcomes of immunotherapy-related liver injury in patients with hepatocellular carcinoma versus other advanced solid tumours.

Despite higher incidence and earlier onset in patients with HCC, IrLI is characterised by high rates of remission, low requirement for corticosteroid therapy and low risk of decompensation compared to other solid tumours. Hepatotoxicity leads to discontinuation in 7% of patients with HCC and does not negatively affect oncological outcomes. Impact and implications Immune-related liver injury (irLI) is common in patients with cancer receiving immune checkpoint inhibitors (ICI), but whether irLI is more frequent or it is associated with a worse clinical course in patients with hepatocellular carcinoma (HCC), compared to other tumours, is not known. Herein, we compared characteristics and outcomes of irLI in two prospective cohorts including patients treated with ICIs for HCC or for other oncological indications. irLI is significantly more common and it occurs earlier in patients with HCC, also after adjustment for duration of treatment exposure. However, outcomes of patients with HCC who developed irLI are not negatively affected in terms of requirement of corticosteroid therapy, hepatic decompensation, treatment discontinuation and overall survival.

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Convergent MAPK pathway alterations mediate acquired resistance to FGFR inhibitors in FGFR2 fusion-positive cholangiocarcinoma.

These findings suggest convergent genomic evolution in the MAPK pathway may be a potential mechanism of acquired resistance to FGFRi. Impact and implications We evaluated tumors and plasma from patients who previously received inhibitors of Fibroblast Growth Factor Receptor (FGFR), an important receptor that plays a role in cancer cell growth, especially in tumors with abnormalities in this gene such as FGFR fusions, where the FGFR gene is fused to another gene, leading to activation of cancer cell growth. We found that patients treated with FGFR inhibitors may develop mutations in other genes such as KRAS, and this can confer resistance to FGFR inhibitors. Clinical trial number NCT02052778.

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Global survey of stigma among physicians and patients with nonalcoholic fatty liver disease.

Perception of NAFLD stigma varies among patients, providers, geographic locations and sub-specialties. - Despite the increasing burden of NAFLD and the fact that over 38% of the world's adult population have NAFLD, disease awareness remains low. One potential issue that may affect awareness is the stigma associated with the terms, "non-alcoholic" and "fatty". In this global study, we found that the terms patients and physicians thought to cause stigma were different. These differences may negatively affect provider-patient communication hindering prompt intervention. These results can help inform education about this liver disease especially as the new nomenclature of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is being implemented. Impact and implications Over the past decades, efforts have been underway to change the nomenclature of NAFLD to better align with its underlying pathogenetic pathways and remove any potential stigma associated with the name. Given the paucity of data related to stigma in NAFLD, we undertook this global comprehensive survey to assess stigma in NAFLD among patients and providers from around the world. We found there is a disconnect between physicians and patients related to stigma and related nomenclature. With this knowledge, educational programs can be developed to better target stigma in NAFLD among al stakeholders and to provide a better opportunity for the new nomenclature to address the issues of stigma.

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Redox-Sensitive High-Mobility Group Box-1 Isoforms Contribute To Liver Fibrosis Progression And Resolution In Mice.

Methods & results Using electrospray ionization-liquid chromatography-mass spectrometry (ESI-LC-MS), we identified that disulfide ([O]) and sulfonated ([SO ] HMGB1 could point at 'resolution under way'. The latter could be used as a readout for response to pharmacological intervention with anti-fibrotic agents.

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Single cell-resolved study of advanced murine MASH reveals a homeostatic pericyte signaling module.

In our current single cell-resolved study of advanced murine MASH we identified a quiescence-associated hepatic stellate cell-signaling module with potential to preserve normal sinusoid function. As expression levels of its constituents are conserved in the human liver, the signaling module may be amenable to therapeutic stimulation for restoration of sinusoid function in chronic liver disease.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: Assessing advanced fibrosis in metabolic-associated steatotic liver disease-The MAFLD fibrosis score.

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Editorial: Liver hypercortisolism as a potential target for MASH treatment.

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Editorial: On-demand vonoprazan for NERD-when should it be 'demanded'?

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Editorial: Unravelling the relationship between periodontal disease and inflammatory bowel disease.

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Gastrointest Endosc

Band-and-sink for GI subepithelial tumors, provided it is not a kitchen-sink approach!

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Endoscopic submucosal dissection versus endoscopic full-thickness resection for challenging colorectal lesions: Must we choose?

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Endoscopic treatment of gastric variceal bleeding: Where have we come from, and where are we going?

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Training endosonographers in needle-based confocal laser endomicroscopy: Is there still a need?

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Weight regain after endoscopic sleeve gastroplasty: retightening the sutures, starting a pill, and more.

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J Hepatol

Genomics on the road to functional cure of hepatitis B.

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Pharmacologic inhibition of lipogenesis for the treatment of NAFLD.

The safety profiles of these compounds have so far remained encouraging. It is anticipated that inhibitors of DNL, when administered alone or in combination with other therapeutic agents, will become important agents in the management of human NAFLD.

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When you eat and when you sleep matters: circadian dysfunction revealed as a direct hepatic carcinogen in a humanized mouse model.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

Emergency pancreatic pseudocyst exploration to retrieve a stent: a nerve-wracking migration.

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Gastric signet-ring cell carcinoma with multiple colorectal metastases.

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Gelée blanche.

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Inverted Pyloric Gland Adenoma of the Duodenum.

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Quality Improvement for Health Care Providers in Gastroenterology and Hepatology.

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Video Endoscopy as Big Data: Balancing Privacy and Progress in Gastroenterology.

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Clin Gastroenterol Hepatol

Accuracy of ChatGPT in Common Gastrointestinal Diseases: Impact for Patients and Providers.

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Endoscopy

A modified closure method during endoscopic full-thickness resection for a gastrointestinal stromal tumor: "neck" clipping and cutting.

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A safe therapeutic strategy for giant pedunculated colorectal polyps with thick stalks.

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Calcified fibrous tumor in the stomach: a rare case of gastric submucosal tumor treated with endoscopic submucosal excavation.

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Diagnosis of a giant gastric subepithelial lesion using a dual-frequency ultrasonic miniprobe.

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Double-endoscope endoscopic submucosal dissection with snare traction and loop stabilization for adenoma involving appendiceal orifice.

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Double-scope technique to recover from hand-suturing trouble in the duodenum.

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Duodenal metal stent deployment using a novel, cholangioscope-guided, guidewire insertion technique.

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Effective management of a retropharyngeal abscess using endoscopic complete-layer resection and drainage.

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Endoscopic ultrasound-guided hepaticogastrostomy with bridging as reintervention for stent occlusion in malignant hilar biliary obstruction.

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Innovations for colonic endoscopic submucosal dissection: combination of the latest game changers.

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Innovative management of intestinal obstruction with colonic transendoscopic enteral tubing.

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Magnet-assisted double-wire technique for patient with difficult endoscopic retrograde cholangiopancreatography cannulation.

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Recurrent obstruction after surgical gastrojejunostomy in a rare case of gastric outlet obstruction: endoscopic ultrasound-guided gastrojejunostomy to the rescue.

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Single-session endoscopic ultrasound-directed transgastric endoscopy for treatment of upper gastrointestinal bleeding after Roux-en-Y gastric bypass.

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Snare-tipped endoscopic radical incision and cutting for postoperative colorectal anastomotic stricture.

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Successful appendiceal incision by endoscopic submucosal dissection to allow endoscopic removal of an encapsulated fecalith.

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Surgical suture-assisted endoscopic band ligation for the management of recurrent hemostasis after unsuccessful use of hemoclips for diverticular bleeding.

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The "furrow sign" in confirming proper gastric extent and direction of the myotomy at the end of peroral endoscopic myotomy.

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The use of an overtube device to assist in advanced therapeutic procedures in patients with a colostomy.

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Underwater endoscopic submucosal dissection with dental floss traction for the treatment of early pharyngeal cancer.

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Gastroenterology

Alcohol Drinking Without Meals Is Associated with Risk of Gastrointestinal Cancers, Including Early-Onset Cases.

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American Indian and Alaska Native Digestive Health: Challenges, Opportunities, and a Path Forward.

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Ethical Considerations for Simultaneous Versus Sequential Liver-Kidney Donation from the Same Live Donor: Donor(s) Selection is Key.

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Incidence of Esophageal Adenocarcinoma Among Symptomatic Reflux Patients Without Erosive Disease on Endoscopy is Similar to the General Population.

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Medicaid Expansion States See Long-Term Improvement in Colorectal Cancer Screening Uptake Among Low-Income Individuals.

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PNPLA3 risk allele association with ALT response to semaglutide treatment.

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Gastrointest Endosc

Anti-reflux mucosal ablation as the rescue therapy for fundoplication failure.

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Biliary cast syndrome developed after treatment for acute cholangitis : Progression to secondary sclerosing cholangitis.

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Continuous wound irrigation and drainage for treating large duodenal contained perforation after endoscopic mucosal resection.

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Direct Intrahepatic Portocaval Shunt Into the Bile Duct: A Rare Case of Jaundice.

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Endoscopic Closure of Refractory External Pancreatic Fistula by Injecting Metal Coil in the Fistula Tract.

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Endoscopic Ultrasound Directed Transgastric ERCP for management of severe hepatic steatosis and fibrosis in a liver transplant patient with bypass anatomy.

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Endoscopic Ultrasound-Guided Cholecystojejunostomy for Management of Acute Cholecystitis in a Patient with Cirrhosis, Ascites and Roux-en-Y Gastric Bypass Anatomy.

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Endoscopic removal of a chicken bone embedded in a child's esophagus.

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Endoscopic submucosal dissection for the treatment of advanced esophageal cancer subsequent to chemotherapy.

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Simultaneous Cesarean Section and Cystogastrostomy with Lumen Apposing Metal Stent Placement in 34 weeks Pregnant Female.

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Splenosis with suspected gastric subepithelial lesion.

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Successful prevention of post-ESD esophageal stenosis using autologous buccal mucosa with polyglycolic acid and self-help inflatable balloon.

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Top Tips: Gastric Peroral Endoscopic Myotomy.

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Transesophageal echocardiography upper esophageal perforation successfully treated with Vacuum-sponge therapy (with video).

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Gut

Antiobesity interventions: options, evidence and value.

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Approaches for greening endoscopy and reducing waste.

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Carbon footprint of gastroenterology practice.

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Climate change, paediatric health and ways that digestive health professionals can engage.

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Effects of climate change on digestive health and preventative measures.

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Gastroenterology climate action opportunities via education, empowerment of trainees and research.

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Green gastroenterology adaptation, resilience and an industry perspective.

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Impact of climate change on vulnerable populations.

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NHS efforts in England to mitigate the climate crisis: uniting nurses and gastroenterologists.

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The fundamentals: understanding the climate change crisis.

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World Gastroenterology Organisation - Gut commentary series on digestive health and climate change.

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Hepatology

Hepatocytes of mice and men: Different regenerative signals?

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July 2023 Hepatology Highlights.

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Letter to the Editor: Lack of complete biochemical response in autoimmune hepatitis leads to adverse outcome: First report of the IAIHG retrospective registry.

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Reply - Lack of complete biochemical response in autoimmune hepatitis leads to adverse outcome: first report of the IAIHG retrospective registry.

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Reply: Alcohol-induced extracellular ASC specks perpetuate liver inflammation and damage in alcohol-associated hepatitis even after alcohol cessation.

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SIRT and chemotherapy in unresectable iCCA: Ready to take off.

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The telomere Tango: Liver disease in the Genomic spotlight.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: Assessing advanced fibrosis in metabolic-associated steatotic liver disease-the MAFLD fibrosis score. Authors' reply.

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Editorial: Liver hypercortisolism as a potential target for MASH treatment-Authors' reply.

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Editorial: On-demand vonoprazan for NERD - when should it be 'demanded'? Authors' reply.

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Letter: Abdominal pain in inflammatory bowel disease patients in remission-A look beyond psychosocial factors.

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Letter: Abdominal pain in patients with inflammatory bowel disease in remission - A look beyond psychosocial factors. Authors' reply.

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Letter: Histological changes among asymptomatic chronic HBV carriers with normal alanine aminotransferase levels-Authors' reply.

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Letter: Histological changes among asymptomatic chronic HBV carriers with normal alanine aminotransferase levels.

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Letter: The importance of histological assessment-a further stride in STRIDE.

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Letter: The importance of histological assessment-a further stride in STRIDE. Authors' reply.

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Letter: Tofacitinib, vedolizumab and ustekinumab in patients with ulcerative colitis-Authors' reply.

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Letter: Tofacitinib, vedolizumab and ustekinumab in patients with ulcerative colitis.

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Clin Gastroenterol Hepatol

Underuse of HCC Surveillance: Not a sign of cynicism.

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Gastroenterology

Psyllium husk positively alters gut microbiota, decreases inflammation and has bowel-regulatory action, paving way for physiological management of irritable bowel syndrome (IBS).

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Residual confounding in the associations between genetic ancestry categories and outcomes.

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Gastrointest Endosc

EUS-guided radiofrequency ablation of pancreatic neoplasm is far from being the new criterion standard.

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Further research is needed to recommend an individualized ERCP position.

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Is hybrid endoscopic full-thickness resection suggested for large nonlifting colorectal adenomas?

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Is topical tranexamic acid combined with endoscopic hemostasis superior to endoscopic hemostasis alone?

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Gut

Practical approach to interpretation of 48-hour wireless pH-monitoring studies.

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Time to focus on the real potential benefit of endobiliary radiofrequency ablation: stent patency in patients with cholangiocarcinoma.

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